Prevalence and Psychosocial Predictors of Body Image Dissatisfaction Among Undergraduate Students in Western Gujarat, India: A Cross-Sectional Study
DOI:
https://doi.org/10.47203/IJCH.2026.v38i05.011Keywords:
Body image; Body image dissatisfaction; Depression; Anxiety; Self-esteem; Undergraduate students; Gujarat; IndiaAbstract
Background: Body image dissatisfaction (BID) is an emerging public health concern among college students due to its association with depression, anxiety, and low self-esteem. Sociocultural pressures during the transition to adulthood increase vulnerability. Evidence from Western Gujarat remains limited.
Objectives: To determine the prevalence of BID and identify its sociodemographic and psychological predictors among undergraduate students in Western Gujarat.
Methods: A cross-sectional study was conducted among 297 undergraduate students (18–24 years) from a medical college in Western Gujarat. Data were collected using a structured questionnaire, including MBSRQ-AS, BDI-II, HAM-A, and RSES. BMI was calculated using standard anthropometric measurements. Data were analyzed using SPSS v25 with chi-square tests, independent t-tests, and binary logistic regression. Statistical significance was set at p < 0.05.
Results: The prevalence of BID was 58.2%. Females reported significantly higher dissatisfaction than males (66.1% vs. 48.5%, p < 0.001). Higher BID was observed among overweight/obese students (75.4%) and underweight students (66.7%). Multivariate analysis identified female gender (AOR = 1.95, 95% CI: 1.13-3.37), overweight/obesity (AOR = 3.59, 95% CI: 1.85-6.97), higher depression scores (AOR = 1.05 per unit), and lower self-esteem (AOR = 0.89 per unit) as independent predictors (Nagelkerke R² = 0.398).
Conclusion: BID is highly prevalent among undergraduate students in Western Gujarat, particularly among females and those with higher BMI, depression, and low self-esteem. Targeted campus-based interventions promoting body positivity, self-esteem, and mental well-being are warranted.
Downloads
References
1. Cash TF, Pruzinsky T. Body Image: A Handbook of Theory, Research, and Clinical Practice. New York: Guilford Press; 2002.
2. Grogan S. Body Image: Understanding Body Dissatisfaction in Men, Women and Children. 3rd ed. New York: Routledge; 2016.
3. Tiggemann M. Body image across the adult life span: stability and change. Body Image. 2004;1(1):29–41.
4. Frederick DA, Fessler DM. Age and body mass on ideal female body shape. Evol Hum Behav. 2007;28(6):458–64.
5. Cash TF, Smolak L. Body Image: A Handbook of Science, Practice, and Prevention. 2nd ed. New York: Guilford Press; 2011.
6. Stice E, Shaw HE. Role of body dissatisfaction in the onset and maintenance of eating pathology. J Psychosom Res. 2002;53(5):985–93.
7. Paxton SJ, Neumark-Sztainer D, Hannan PJ, Eisenberg ME. Body dissatisfaction prospectively predicts depressive mood and low self-esteem in adolescent girls and boys. J Clin Child Adolesc Psychol. 2006;35(4):539–49.
8. Mond J, Hay PJ, Rodgers B, Owen C. Mental health impairment associated with body dissatisfaction: community-based study. Aust N Z J Psychiatry. 2013;47(6):485–90.
9. Ricciardelli LA, McCabe MP. Children’s body image concerns and eating disturbance: a review of the literature. Clin Psychol Rev. 2001;21(3):325–44.
10. Dey PK, Chaudhuri A, Dasgupta A, Ray S. Body image perception and its association with BMI among college students in Kolkata, India. Indian J Community Med. 2020;45(4):447–51.
11. Yadav PK, Shukla M, Gupta A. Media exposure and body dissatisfaction among Indian adolescents. Int J Adolesc Med Health. 2021;33(3):1–7.
12. Banerjee S, Mukherjee A. Gender differences in body image dissatisfaction among Indian college students. Psychol Stud (Mysore). 2018;63(1):57–63.
13. Sharma N, Choudhary R, Mehta S. Body image perception and mental health correlates among Indian youth. Asian J Psychiatr. 2019;42:65–71.
14. Shukla A, Patel R, Gohil P. Prevalence and correlates of body image dissatisfaction among undergraduate students in Gujarat. J Family Med Prim Care. 2021;10(6):2245–51.
15. Swami V, Tovée MJ. Perceptions of female body weight and shape among indigenous and urban populations in Malaysia. Br J Psychol. 2007;98(2):137–52.
16. Patel D, Rathod S, Shah M. Sociocultural predictors of body image dissatisfaction among Gujarati college students. Indian J Public Health Res Dev. 2020;11(8):159–64.
17. Muth JL, Cash TF. Body-image attitudes: what difference does gender make? J Appl Soc Psychol. 1997;27(16):1438–52.
18. Griffiths S, Hay P, Mitchison D. Self‑esteem and body image in eating disorders: a meta‑analysis. J Eat Disord. 2021;9(1):1–14.
19. Van den Berg P, Mond J, Eisenberg M, Ackard D, Neumark-Sztainer D. The link between body dissatisfaction and self-esteem in adolescents: importance of body weight and gender. Body Image. 2010;7(4):257–60.
20. Setia MS. Methodology series module 3: Cross-sectional studies. Indian J Dermatol. 2016;61(3):261–264.
21. Arnett JJ. Emerging adulthood: A theory of development from the late teens through the twenties. Am Psychol. 2000;55(5):469–480.
22. Krejcie RV, Morgan DW. Determining sample size for research activities. Educ Psychol Meas. 1970;30(3):607–610.
23. Elfil M, Negida A. Sampling methods in clinical research: An educational review. Emerg (Tehran). 2017;5(1):e52.
24. Boynton PM, Greenhalgh T. Selecting, designing, and developing your questionnaire. BMJ. 2004;328(7451):1312–1315.
25. Cash TF. MBSRQ Users’ Manual. 3rd ed. Norfolk, VA: Old Dominion University; 2000.
26. Brown TA, Cash TF, Mikulka PJ. Attitudinal body-image assessment: Factor analysis of the Body-Self Relations Questionnaire. J Pers Assess. 1990;55(1–2):135–144.
27. Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation; 1996.
28. Dozois DJA, Dobson KS, Ahnberg JL. A psychometric evaluation of the Beck Depression Inventory–II. Psychol Assess. 1998;10(2):83–89.
29. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32(1):50–55.
30. Maier W, Buller R, Philipp M, Heuser I. The Hamilton Anxiety Scale: reliability, validity and sensitivity to change in anxiety and depressive disorders. J Affect Disord. 1988;14(1):61–68.
31. Shear MK, Vander Bilt J, Rucci P, Endicott J, Lydiard B, Otto MW, et al. Reliability and validity of a structured interview guide for the Hamilton Anxiety Rating Scale (SIGH-A). Depress Anxiety. 2001;13(4):166–178.
32. Rosenberg M. Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press; 1965.
33. Sinclair SJ, Blais MA, Gansler DA, Sandberg E, Bistis K, LoCicero A. Psychometric properties of the Rosenberg Self-Esteem Scale: Overall and across demographic groups living within the United States. Eval Health Prof. 2010;33(1):56–80.
34. Schmitt DP, Allik J. Simultaneous administration of the Rosenberg Self-Esteem Scale in 53 nations: exploring the universal and culture-specific features of global self-esteem. J Pers Soc Psychol. 2005;89(4):623–642.
35. World Health Organization. Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series No. 854. Geneva: WHO; 1995.
36. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–163.
37. Verma M, Rajput M, Kishore K, Kathirvel S. Asian BMI criteria are better than WHO criteria in predicting hypertension: a cross-sectional study from rural India. J Family Med Prim Care. 2019;8(6):2095–2101.
38. Misra A, Chowbey P, Makkar BM, et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India. 2009;57:163–170.
39. WHO Expert Consultation. Waist Circumference and Waist–Hip Ratio: Report of a WHO Expert Consultation, Geneva, 8–11 December 2008. Geneva: World Health Organization; 2011.
40. Eysenbach G, Wyatt J. Using the Internet for surveys and health research. J Med Internet Res. 2002;4(2):E13.
41. Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Designing Clinical Research. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013.
42. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194.
43. Indian Council of Medical Research. National Ethical Guidelines for Biomedical and Health Research Involving Human Participants. New Delhi: ICMR; 2017.
44. Gøtzsche PC. Reference guide to randomised controlled trials: protection against bias. Lancet. 2001;358(9289):1226–1229.
45. Walkenbach J. Excel 2019 Bible. Indianapolis, IN: John Wiley & Sons; 2018.
46. Altman DG, Bland JM. Statistics notes: Presentation of numerical data. BMJ. 1996;312(7030):572.
47. Shapiro SS, Wilk MB. An analysis of variance test for normality (complete samples). Biometrika. 1965;52(3–4):591–611.
48. Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. 10th ed. Philadelphia, PA: Wolters Kluwer; 2017.
49. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
50. Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;3:17.
51. Hosmer DW, Lemeshow S, Sturdivant RX. Applied Logistic Regression. 3rd ed. Hoboken, NJ: John Wiley & Sons; 2013.
52. Hosmer DW, Lemeshow S. Goodness of fit tests for the multiple logistic regression model. Commun Stat Theory Methods. 1980;9(10):1043–1069.
53. Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis. 7th ed. Upper Saddle River, NJ: Prentice Hall; 2010.
54. Pearson K. Notes on regression and inheritance in the case of two parents. Proc R Soc Lond. 1895;58:240–242.
55. Hinkle DE, Wiersma W, Jurs SG. Applied Statistics for the Behavioral Sciences. 5th ed. Boston, MA: Houghton Mifflin; 2003.
56. Altman DG, Bland JM. Interaction revisited: the difference between two estimates. BMJ. 2003;326(7382):219.
57. von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–1457.
58. Little RJA, Rubin DB. Statistical Analysis with Missing Data. 2nd ed. Hoboken, NJ: John Wiley & Sons; 2002.
59. Kapoor A, Upadhyay MK, Saini NK. Prevalence, patterns, and determinants of body image dissatisfaction among female undergraduate students of University of Delhi. J Family Med Prim Care. 2022;11(5):2002–2007.
60. Ganesan S, Ravishankar SL, Ramalingam S. Are body image issues affecting our adolescents? A cross-sectional study among college going adolescent girls. Indian J Community Med. 2018;43(Suppl 1):S42–S46.
61. Diengdoh I, Ali A. Body image and its association with depression, anxiety, and self-esteem among college going students: a study from Northeast India. Indian J Community Med. 2022;47(2):218–222.
62. Singh S, Gadiraju P. Prevalence and correlates of body dissatisfaction and disordered eating patterns in Indian youth: the role of media. Indian J Psychiatry. 2020;62(5):509–516.
63. Milton A, Hambleton A, Roberts A, Davenport T, Flego A, Burns J, et al. Body image distress and its associations from an international sample of men and women across the adult life span: web-based survey study. JMIR Form Res. 2021;5(11):e25329.
64. Divecha CA, Simon MA, Asaad AA, Tayyab H. Body image perceptions and body image dissatisfaction among medical students in Oman. Sultan Qaboos Univ Med J. 2022;22(2):218–224.
Downloads
Published
Data Availability Statement
Data stored is available with the Author.
Issue
Section
License
Copyright (c) 2026 KADALARASU D, Rohitkumar Ram, Hemangi Ladani (Author); Yogesh M (Corresponding Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
